Customers Health Declaration Form
For the safety of our community, declaration of health is required. Be sure that the information you'll give is accurate and complete.
Thank you for your kind cooperation.
Mall Entry Station *
Date *
MM
/
DD
/
YYYY
Time *
Time
:
Full Name *
Your answer
IC No. / Passport / ID No. *
Your answer
Contact No. *
Your answer
Body Temperature *
Your answer
Declaration From Customer *
Required
Submit
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